OVERALL DESCRIPTION: (Adapted from applicant's abstract): The Center under-takes research directed at identifying and evaluating innovative financing and organizational approaches to the care of individuals with severe mental illnesses (SMI). Priority is given to those options expected to have substantial impact on functional status and quality of life for persons with SMI, as well as those expected to improve efficiency of the care system. Core funding is directed toward pilot and developmental studies that are expected to lead to major research and demonstration initiatives for which new sources of funding are sought. Research objectives of the Center are directed at four policy relevant areas: Assess the impact of the course of severe mental illnesses, and their associated problems, on service needs and the patterns of treatment; assess the effectiveness and costs of alternative treatment approaches for persons with SMI which are based on treatment models with established efficacy or accepted practice, and develop and test quality of care criteria for matching treatment needs to services for patients with severe mental illnesses; examine the role of financing mechanisms as a means to encourage efficiency, assure access to appropriate care for the SMI, and provide incentives for enhancing patient outcomes, including dimensions of mental status, physical status, adequacy of living arrangements, and quality of life; and examine alternative organizational and system approaches for managing resources, coordinating services to persons with SMI, and evaluate their impact on utilization, housing general medical care, and resources including income support and payment for treatment and related services. The Center has pursued these objectives since 1987. During the next 5 years, two core research areas will be pursued: organization and finance research, and clinical services research. The Center represents a collaborative effort of the School of Hygiene and Public Health and School of Medicine of the Johns Hopkins University, and the Center for Mental Health Services Research of the Department of Psychiatry of the University of Maryland.